title: Dietary changes during pregnancy and the postpartum period in Singaporean Chinese, Malay and Indian women: the GUSTO birth cohort study.
abstract: OBJECTIVE
  To examine changes in food consumption during pregnancy and the postpartum period in women of major Asian ethnic groups.
  
  
  METHODS
  Using interviewer-administered questionnaires, we assessed changes in food consumption during pregnancy (26-28 weeks' gestation) and the postpartum period (3 weeks after delivery) as compared with the usual pre-pregnancy diet.
  
  
  METHODS
  Singapore.
  
  
  METHODS
  Pregnant women (n 1027) of Chinese, Malay and Indian ethnicity (mean age 30·4 (SD 5·2) years) who participated in the Growing Up in Singapore Towards healthy Outcomes (GUSTO) study.
  
  
  RESULTS
  During pregnancy, participants tended to increase their consumption of milk, fruit and vegetables and decrease their consumption of tea, coffee, soft drinks and seafood (all P < 0·001). Most participants reported adherence to traditional restrictions ('confinement') during the early postpartum period (Chinese: 94·8 %, Malay: 91·6 %, Indian: 79·6 %). During the postpartum period, participants tended to increase their consumption of fish and milk-based drinks and decrease their consumption of noodles, seafood, and chocolates and sweets (all P < 0·001). Ethnic differences in food consumption were pronounced during the postpartum period. For example, most Chinese participants (87·2 %) increased their ginger consumption during the postpartum period as compared with smaller percentages of Malays (31·8 %) and Indians (40·8 %; P for ethnic difference <0·001). Similar ethnic differences were observed for cooking wine/alcohol, herbs and spices, and herbal tea consumption.
  
  
  CONCLUSIONS
  Marked changes in food consumption that reflect both modern dietary recommendations and the persistence of traditional beliefs were observed in Singaporean women during pregnancy and the postpartum period. Traditional beliefs should be considered in interventions to improve dietary intakes during these periods.
authors.affiliation: 1Saw Swee Hock School of Public Health,National University of Singapore,Block MD3,16 Medical Drive,Singapore117597.
authors.forename: Ling-Wei
authors.initials: LW
authors.lastname: Chen
authors.affiliation: 1Saw Swee Hock School of Public Health,National University of Singapore,Block MD3,16 Medical Drive,Singapore117597.
authors.forename: Yen Ling
authors.initials: YL
authors.lastname: Low
authors.affiliation: 2National UniversityHealth System,Singapore.
authors.forename: Doris
authors.initials: D
authors.lastname: Fok
authors.affiliation: 3KK Women's and Children's Hospital,Singapore.
authors.forename: Wee Meng
authors.initials: WM
authors.lastname: Han
authors.affiliation: 4Department of Obstetrics and Gynaecology,Yong Loo Lin School of Medicine,National University of Singapore,Singapore.
authors.forename: Yap Seng
authors.initials: YS
authors.lastname: Chong
authors.affiliation: 5Growth,Development and Metabolism Program,Singapore Institute for Clinical Sciences,A*STAR,Singapore.
authors.forename: Peter
authors.initials: P
authors.lastname: Gluckman
authors.affiliation: 6Medical Research Council Lifecourse Epidemiology Unit and NIHR Southampton Biomedical Research Centre,University of Southampton and University Hospital Southampton NHS Foundation Trust,Southampton,UK.
authors.forename: Keith
authors.initials: K
authors.lastname: Godfrey
authors.affiliation: 3KK Women's and Children's Hospital,Singapore.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Kwek
authors.affiliation: 1Saw Swee Hock School of Public Health,National University of Singapore,Block MD3,16 Medical Drive,Singapore117597.
authors.forename: Seang-Mei
authors.initials: SM
authors.lastname: Saw
authors.affiliation: 1Saw Swee Hock School of Public Health,National University of Singapore,Block MD3,16 Medical Drive,Singapore117597.
authors.forename: Shu E
authors.initials: SE
authors.lastname: Soh
authors.affiliation: 3KK Women's and Children's Hospital,Singapore.
authors.forename: Kok Hian
authors.initials: KH
authors.lastname: Tan
authors.affiliation: 8Clinical Nutrition Research Centre,Singapore Institute for Clinical Sciences,14 Medical Drive,#07-02,Singapore 117599.
authors.forename: Mary Foong Fong
authors.initials: MF
authors.lastname: Chong
authors.affiliation: 1Saw Swee Hock School of Public Health,National University of Singapore,Block MD3,16 Medical Drive,Singapore117597.
authors.forename: Rob M
authors.initials: RM
authors.lastname: van Dam
mesh_terms: D000328:Adult; D002681:China / Q000208:ethnology; D015331:Cohort Studies; D004032:Diet / Q000009:adverse effects / Q000208:ethnology; D005260:Female; D006293:Health Promotion; D006801:Humans; D007194:India / Q000208:ethnology; D008296:Malaysia / Q000208:ethnology; D039382:Maternal Nutritional Physiological Phenomena / Q000208:ethnology; D008519:Medicine, Traditional; D018673:Nutrition Policy; D010349:Patient Compliance / Q000208:ethnology; D049590:Postpartum Period; D011247:Pregnancy; D012846:Singapore; D055815:Young Adult